Individual
MRS. NICOLE MARIE FABRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4171 HWY 1 S. STE 10, PORT ALLEN, LA 70767
(225) 416-0333
(225) 416-0332
Mailing address
4171 HWY 1 S. STE 10, PORT ALLEN, LA 70767
(225) 416-0333
(225) 416-0332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
07341
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1693081
—
LA
05
—
2520423
—
LA
01
—
721342481
TAX ID
LA
01
—
721512274
TAX ID
LA
Enumeration date
03/10/2008
Last updated
03/22/2023
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